Alhusayni Abdullah Ibrahim, Cowey Eileen Stewart, Coulter Elaine, Barber Mark, Paul Lorna
College of Applied Medical Sciences, Shaqra University, Sahqra 11961, Saudi Arabia.
Nursing & Health Care School, University of Glasgow, Scotland G12 8QQ, UK.
Healthcare (Basel). 2023 Sep 19;11(18):2582. doi: 10.3390/healthcare11182582.
BACKGROUND: After a stroke, inpatients often receive less than the recommended dose of therapy. Telerehabilitation may assist by providing personalised rehabilitation programmes without face-to-face therapy time. This study aimed to evaluate the acceptability and feasibility of an individualised programme of upper-limb rehabilitation that is delivered via an online rehabilitation platform for inpatient stroke survivors. METHODS: Stroke survivors were recruited from three stroke units in one NHS Board in Scotland and randomised to the intervention (personalised upper-limb exercise programme delivered via an online physiotherapy platform for four weeks, up to 30 min five times per week, in addition to usual care) or the control group (usual care). The main outcomes are related to recruitment, attrition, adherence and safety. The clinical measures were the Action Research Arm Test, Trunk Impairment Scale and Modified Ashworth Scale. The intervention participants, their carers and physiotherapists completed questionnaires on the acceptability of the intervention. RESULTS: Twenty-six participants, 42% males, were recruited around three weeks post-stroke, on average. There were 13 participants in each group, with a mean age of 69 years (SD of 12) and 67 years (SD of 11) for the control and intervention groups, respectively. Overall, 47% of those screened for eligibility were randomised, and attrition was 23% in the intervention group mainly due to discharge before the end of the intervention. Participants who adhered to their programme (completed more than two-thirds), generally those with an engaged carer, demonstrated a trend toward improved clinical outcomes. Overall, the patients, carers and physiotherapists were positive regarding the intervention. There was a total of five reported adverse events, none of which were related to the study. CONCLUSION: An upper-limb unsupervised exercise intervention using an online physiotherapy platform for inpatient stroke survivors is feasible, safe and acceptable to patients, carers and physiotherapists. A fully powered RCT is warranted to investigate the clinical- and cost-effectiveness of such interventions for this patient group.
背景：中风后，住院患者接受的治疗剂量往往低于推荐剂量。远程康复可通过提供个性化康复方案来提供帮助，而无需面对面治疗时间。本研究旨在评估通过在线康复平台为中风住院幸存者提供的个性化上肢康复方案的可接受性和可行性。 方法：从苏格兰一个国民保健服务委员会的三个中风单元招募中风幸存者，并随机分为干预组（通过在线物理治疗平台提供个性化上肢锻炼方案，为期四周，每周五次，每次最多30分钟，此外还接受常规护理）或对照组（常规护理）。主要结果与招募、损耗、依从性和安全性有关。临床测量指标为行动研究臂试验、躯干损伤量表和改良Ashworth量表。干预组参与者、他们的护理人员和物理治疗师完成了关于干预可接受性的问卷调查。 结果：平均而言，在中风后约三周招募了26名参与者，其中42%为男性。每组有13名参与者，对照组和干预组的平均年龄分别为69岁（标准差12）和67岁（标准差11）。总体而言，47%符合入选标准的人被随机分组，干预组的损耗率为23%，主要原因是在干预结束前出院。坚持方案（完成超过三分之二）的参与者，通常是有积极参与的护理人员的参与者，显示出临床结果改善的趋势。总体而言，患者、护理人员和物理治疗师对干预持积极态度。共报告了5起不良事件，均与研究无关。 结论：使用在线物理治疗平台为中风住院幸存者提供的上肢无监督锻炼干预对患者、护理人员和物理治疗师来说是可行、安全且可接受的。有必要进行一项充分有力的随机对照试验，以研究此类干预对该患者群体的临床和成本效益。
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